I’ve been percolating on the ideas presented by Dr. John Carpente in a blog post he wrote this week in which he explores the concept of music being “used” in therapy as opposed to music being “worked in” in therapy. It’s not a new conversation—I usually read about the music AS versus music IN therapy concept—yet it’s an important dialogue to engage in as it ties into our identity as music therapists and the uniqueness of our craft.
John, you invited your readers to share our thoughts. For what it’s worth, here are mine:
First, I resonate with the concept of “working in” music. It’s a phrase I have not heard or considered before, but I like the musically interactive aspect that is implied.
The challenge for me is the dichotomous presentation of the idea of “using” music versus “working in” music. Although not directly stated, it seems as if part of the argument is that since other professionals can “use” music in their practive, we as music therapists shouldn’t. For if we “use” music in our practice, how would that differentiate our work from the work of another therapy professional?
This is a challenge as in my experience there are times when it is clinically appropriate for a music therapist to “use” music in a stimulus-response fashion. I have done so many times in neurorehabilitation settings where I have “used” and manipulated the music stimulus to facilitate, enhance, and/or direct a gross, fine, or oral motor skill. In these instances I was not the one who created the skill (i.e. goal) that needed to be addressed—that came from the physical therapist, occupational therapist, or speech language pathologist—but I was the master musician who was able to create and present the music stimulus in such a way as to maximize its effect.
My first inclination was to envision this implied dichotomy as a continuum. What if our work fell somewhere on a continuum between “using” and “working in” music? Following this idea, where we sit on the continuum at any given time could be informed by therapist personality, therapist experience, clinical setting, and client need. There’s a fluidity to the continuum concept that is attractive to me as it allows the music therapist flexibility in his or her practice based on what is needed in any given moment.
But then I got stuck on the description of “working in” music, which John writes relates to the aesthetic and relational elements of the therapeutic music experience. If we continue with the continuum concept, it follows that there may be times when there is not an aesthetic or relational component. But as a master musician, how can you create music that isn’t aesthetically pleasing—isn’t that a large part of our clinical musicianship training? To be able to create music in such a way that is functional, but also aesthetically pleasing? And what about the relational component—even when you are “using” music there is a human element involved in the experience. It may or may not directly relate to how the music experience is structured, but a therapeutic experience likely has a relational component.
So where does that leave us? Unfortunately without any answers…but what I am mulling now is the concept that perhaps “working in” music is always a part of music therapy practice. It’s always there regardless of how we are working in music. To provide a visual, envision “working in” music as a circle. And perhaps inside the circle there is a continuum of “using” music. On one end is the stimulus response model and at the other end…well, I’m not really sure what to call that, yet, but perhaps it has to do with music creation (e.g. improvisation or music making). The stimulus response end implies that the client is a passive experiencer of the music experience, whereas the music creation end implies active engagement in and, yes, working in music. But what surrounds the continuum, what envelops it is the circle, the aesthetic and relational elements of the music therapy process. You can’t take those away regardless of how the music therapy is structured and experienced.